The Only Cure opens with an arresting historical observation: in the 1960s, more than half of American psychiatrists were psychoanalysts; today, their numbers have dwindled to single digits. Solms uses this stark contrast to frame the book’s central concern, the precipitous fall of psychoanalysis and the corresponding rise of biological psychiatry, and to ask what has been lost in the process. His answer is uncompromising: psychiatry has abandoned its only genuine cure.

The book sets out to rehabilitate Sigmund Freud as a serious scientist rather than as a speculative thinker or cultural relic. Solms argues that Freud’s metapsychological model was not only coherent but prescient, anticipating many of the central findings of contemporary cognitive and affective neuroscience. He goes so far as to suggest that ideological resistance to Freud in the latter half of the 20th century actively delayed neuroscientific progress. The result, he claims, is a mental health system that relies heavily on symptom management while offering little in the way of cure, something he describes, without hesitation, as a scandal.

A major theme of the book is the convergence between modern neuroscience and psychoanalytic theory. Solms reviews developments in the understanding of consciousness, affect, embodied cognition, predictive perception, multiple memory systems, unconscious mental life and the decisive role of early experience, arguing that all are strikingly consistent with Freud’s original account of the mental apparatus. Freud’s conjecture regarding multiple memory systems, for example, has proved profoundly fruitful for neuroscience, particularly in relation to non-declarative memory and its resistance to rapid change. On this view, repetition compulsion and transference are not metaphors but neuropsychological realities, rooted in subcortical systems that can be modified only slowly, through time and relationship.

One of the book’s strengths is Solms’ authority. Few living scholars have worked as intimately with Freud’s original texts, having spent decades editing and retranslating Freud’s neuroscientific writings and correspondence. This depth of scholarship allows Solms to challenge familiar accusations, particularly around Freud’s views on sexuality, with confidence and historical precision. He also draws effectively on neuroscientific examples, including imaging studies of dreaming that support motivational and wish-fulfilling dimensions of mental life.

In my view, the book succeeds powerfully in its central aim: to undermine the claim that psychoanalysis is unscientific. By demonstrating how closely contemporary neuroscience aligns with Freud’s core insights, Solms reframes psychoanalysis not as an outdated rival to biology, but as its necessary partner. I should also be transparent about my own standpoint. I am broadly persuaded by Solms’ argument, not least because my own experience of psychoanalysis was profoundly transformative. For me, it was the only treatment that brought lasting change.

One thing is for sure: psychoanalysis is lucky to have Mark Solms in its corner.